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Background: Cigar use among adults in the United States has remained relatively stable in the past decade and occupies a growing part of the tobacco marketplace as cigarette use has declined. While studies have established the detrimental respiratory health effects of cigarette use, the effects of cigar use need further characterization. In this study, we evaluate the prospective association between cigar use, with or without cigarettes, and asthma exacerbation. Methods: We used data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study to run generalized estimating equation models examining the association between time-varying, one-wave-lagged cigarette and cigar use and self-reported asthma exacerbation among US adults (18+). We defined our exposure as non-established (reference), former, exclusive cigarette, exclusive cigar, and dual use. We defined an asthma exacerbation event as a reported asthma attack in the past 12 months necessitating oral or injected steroid medication or asthma symptoms disrupting sleep at least once a week in the past 30 days. We adjusted for age, sex, race and ethnicity, household income, health insurance, established electronic nicotine delivery systems use, cigarette pack-years, secondhand smoke exposure, obesity, and baseline asthma exacerbation. Results: Exclusive cigarette use (incidence rate ratio (IRR): 1.26, 95% confidence interval (CI): 1.03–1.54) and dual use (IRR: 1.41, 95% CI: 1.08–1.85) were associated with a higher rate of asthma exacerbation compared to non-established use, while former use (IRR: 1.01, 95% CI: 0.80–1.28) and exclusive cigar use (IRR: 0.70, 95% CI: 0.42–1.17) were not. Conclusion: We found no association between exclusive cigar use and self-reported asthma exacerbation. However, exclusive cigarette use and dual cigarette and cigar use were associated with higher incidence rates of self-reported asthma exacerbation compared to non-established use. Studies should evaluate strategies to improve cigarette and cigar smoking cessation among adults with asthma who continue to smoke. [ABSTRACT FROM AUTHOR]

Despite its importance to everyday functioning, reasoning is underexplored in developmental dyslexia. The current study investigated verbal deductive reasoning on the Wason selection task, not previously used in dyslexia research despite its well-established pedigree. Reasoning rule was manipulated, with the conditional rules varying in the logical values presented. The word frequency and imageability of the word terms was also manipulated. Twenty-six adults with dyslexia and 31 adults without dyslexia completed Wason selection task problems. No group difference in reasoning accuracy or completion time was found. However, the participants were most accurate when reasoning with the rule type "If p, then not q" and least accurate with the rule type "If p then q". More trials were also answered correctly when the word terms were highly imageable but of average word frequency. These findings are in line with the general reasoning literature. Dyslexia status did not interact with either rule type or word term type. The study expands upon previous research by testing verbal deductive reasoning in dyslexia, highlighting the role of imageability in facilitating reasoning performance for all, regardless of the presence or absence of dyslexia. Implications for the design of educational materials are considered. [ABSTRACT FROM AUTHOR]

As government documents, postage stamps are a rich source of information about a government's policies on a wide range of subjects. In this article, a comparative semiotic analysis of the first seventy-five years of North and South Korean stamps is used to illustrate the similarities and differences in their attitudes towards 'religion' and religious practice. A corpus of stamps on a 'religious' theme was created for stamps issued by both governments from which a series of themes and motifs was noted. The semiotic analysis of the themes and motifs showed that while on South Korean stamps Buddhist motifs constituted the majority of stamps commemorating cultural history, there were few references to the commemoration of Buddhism itself. The reverse was found to be true for Christianity. Although Christianity was not shown to be a major expression of Korean culture, Christianity itself was commemorated extensively. On North Korean stamps, folklore and Christian motifs predominated as projections of cultural history, but the Christian motifs referred only to foreign cultures, not Korean culture. Motifs relating to the foundation myth of Tan'gun were common to both North and South Korea. However, in the South, motifs from the myth referred to the nation, while in the North they referred to the ruling family. [ABSTRACT FROM AUTHOR]

As part of the Pandonia Global Network (PGN), Pandora spectrometers are widely deployed around the world. These ground-based, remote-sensing instruments are federated such that they employ a common algorithm and data protocol for reporting on trace gas column densities and lower atmospheric profiles using two modes based on direct-sun and sky-scan observations. To aid users in the analysis of Pandora observations, the PGN standard quality assurance procedure assigns flags to the data indicating high, medium, and low quality. This work assesses the suitability of these data quality flags for filtering data in the scientific analysis of nitrogen dioxide (NO2) and formaldehyde (HCHO), two critical precursors controlling tropospheric ozone production. Pandora data flagged as high quality assures scientifically valid data and is often more abundant for direct-sun NO2 columns. For direct-sun HCHO and sky-scan observations of both molecules, large amounts of data flagged as low quality also appear to be valid. Upon closer inspection of the data, independent uncertainty is shown to be a better indicator of data quality than the standard quality flags. After applying an independent uncertainty filter, Pandora data flagged as medium or low quality in both modes can be demonstrated to be scientifically useful. Demonstrating the utility of this filtering method is enabled by correlating contemporaneous but independent direct-sun and sky-scan observations. When evaluated across 15 Pandora sites in North America, this new filtering method increased the availability of scientifically useful data by as much as 90 % above that tagged as high quality. A method is also developed for combining the direct-sun and sky-scan observations into a single dataset by accounting for biases between the two observing modes and differences in measurement integration times. This combined data provides a more continuous record useful for interpreting Pandora observations against other independent variables such as hourly observations of surface ozone. When Pandora HCHO columns are correlated with surface ozone measurements, data filtered by independent uncertainty exhibits similarly strong and more robust relationships than high-quality data alone. These results suggest that Pandora data users should carefully assess data across all quality flags and consider their potential for useful application to scientific analysis. The present study provides a method for maximizing use of Pandora data with expectation of more robust satellite validation and comparisons with ground-based observations in support of air quality studies. [ABSTRACT FROM AUTHOR]

Understanding how the early stages of sexual signal diversification proceed is critically important because these microevolutionary dynamics directly shape species trajectories and impact macroevolutionary patterns. Unfortunately, studying this is challenging because signals involve complex interactions between behavior, morphology, and physiology, much of which can only be measured in real-time. In Hawaii, male Pacific field cricket song attracts both females and a deadly parasitoid fly. Over the past two decades, there has been a marked increase in signal variation in Hawaiian populations of these crickets, including novel male morphs with distinct mating songs. We capitalize on this rare opportunity to track changes in morph composition over time in a population with three novel morphs, investigating how mate and parasitoid attraction (components of sexual and natural selection) may shape signal evolution. We find dramatic fluctuation in morph proportions over the three years of the study, including the arrival and rapid increase of one novel morph. Natural and sexual selection pressures act differently among morphs, with some more attractive to mates and others more protected from parasitism. Collectively, our results suggest that differential protection from parasitism among morphs, rather than mate attraction, aligns with recent patterns of phenotypic change in the wild. [ABSTRACT FROM AUTHOR]

The Forest Fire Danger Index (FFDI) is the main measure used in Australia for estimating fire risk. Recent work by the authors showed that the FFDI forms stable state regimes, nominated as fire climate regimes. These regimes shifted to greater intensity in southern and eastern Australia around the year 2000 and, a decade later, further north. Reductions in atmospheric moisture were the primary contributor. These changes have not been fully incorporated into future projections. This paper compares the recent regime shifts with the most recent national projections of FFDI, published in 2015. They show that for most states and regions, the 2030 upper limit is approached or exceeded by the recent shift, except for two states with large arid zones, South Australia and Western Australia. Methods for attributing past changes, constructing projections, and the inability of climate models to reproduce the recent decreases in atmospheric moisture, all contribute to these underestimates. To address these shortcomings, we make some suggestions to modify efforts aiming to develop seamless predictions and projections of future fire risk. [ABSTRACT FROM AUTHOR]

Background Community-acquired pneumonia is a well-studied condition; yet, in the urgent care setting, patient characteristics and adherence to guideline-recommended care are poorly described. Within Intermountain Health, a nonprofit integrated US health care system based in Utah, more patients present to urgent care clinics (UCCs) than emergency departments (EDs) for pneumonia care. Methods We performed a retrospective cohort study 1 January 2019 through 31 December 2020 in 28 UCCs within Utah. We extracted electronic health record data for patients aged ≥12 years with ICD-10 pneumonia diagnoses entered by the bedside clinician, excluding patients with preceding pneumonia within 30 days or missing vital signs. We compared UCC patients with radiographic pneumonia (n = 4689), without radiographic pneumonia (n = 1053), without chest imaging (n = 1472), and matched controls with acute cough/bronchitis (n = 15 972). Additional outcomes were 30-day mortality and the proportion of patients with ED visits or hospital admission within 7 days after the index encounter. Results UCC patients diagnosed with pneumonia and possible/likely radiographic pneumonia by radiologist report had a mean age of 40 years and 52% were female. Almost all patients with pneumonia (93%) were treated with antibiotics, including those without radiographic confirmation. Hospital admissions and ED visits within 7 days were more common in patients with radiographic pneumonia vs patients with "unlikely" radiographs (6% vs 2% and 10% vs 6%, respectively). Observed 30-day all-cause mortality was low (0.26%). Patients diagnosed without chest imaging presented similarly to matched patients with cough/acute bronchitis. Most patients admitted to the hospital the same day after the UCC visit (84%) had an interim ED encounter. Pneumonia severity scores (pneumonia severity index, electronic CURB-65, and shock index) overestimated patient need for hospitalization. Conclusions Most UCC patients with pneumonia were successfully treated as outpatients. Opportunities to improve care include clinical decision support for diagnosing pneumonia with radiographic confirmation and development of pneumonia severity scores tailored to the UCC. [ABSTRACT FROM AUTHOR]

Background: While regular cigar smoking is believed to carry similar health risks as regular cigarette smoking, the impact of cigar use, alone or in combination with cigarettes, on obstructive pulmonary disease (COPD) has not been well characterized. The purpose of this study was to examine the prospective association between exclusive and dual cigar and cigarette use and incident self-reported diagnosed COPD. Methods: This study used data from Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative survey of U.S. adults. Longitudinal data from adults aged 40 to 79 at Wave 1, without a pre-existing COPD diagnosis who participated at follow-up interview were analyzed. A time-varying current tobacco exposure, lagged by one wave and categorized as: (a) never/non-current use; (b) exclusive cigar use; (c) exclusive cigarette use; and (d) dual cigar/cigarette use. Multivariable models adjusted for demographics (age, sex, race or ethnicity, education), clinical risk factors (asthma, obesity), and smoking-related confounders (second-hand smoke exposure, other combustible tobacco product use, e-cigarette use, time since quitting, cigarette pack-years). The incidence of self-reported diagnosed COPD was estimated using discrete-time survival models, using a general linear modeling (GLM) approach with a binomial distribution and a complementary log-log link function. Results: The analytic sample consisted of 9,556 adults with a mean (SD) age of 56 (10.4), who were predominately female (52.8%) and Non-Hispanic White (70.8%). A total of 906 respondents reported a diagnosis of COPD at follow-up. In the fully adjusted model, exclusive cigar use (adjusted hazard ratio (aHR) = 1.57, 95% CI: 0.77, 3.21) was not associated with increased COPD risk compared to non-use, while exclusive cigarette use (aHR = 1.48, 95% CI: 1.13, 1.93) and dual cigar/cigarette use (aHR = 1.88, 95% CI: 1.24, 2.85) were. Conclusions: Exclusive cigarette use and dual cigar/cigarette use were associated with diagnosed incident COPD. These results suggest that cigars, when used in combination with cigarettes, may be associated with poorer COPD health outcomes. Dual use may promote a higher likelihood of inhaling cigar smoke, and future research would benefit from examining whether inhalation of cigar smoke increases COPD risk. [ABSTRACT FROM AUTHOR]

Background Internal medicine residents frequently experience distressing clinical events; critical event debriefing is one tool to help mitigate their effects. Objective To evaluate the effectiveness of a 1-hour workshop teaching residents a novel, efficient approach to leading a team debrief after emotionally charged clinical events. Methods An internal needs assessment identified time and confidence as debriefing barriers. In response, we created the STREAM (Structured, Timely, Reflection, tEAM-based) framework, a 15-minute structured approach to leading a debrief. Senior residents participated in a 1-hour workshop on the first day of an inpatient medicine rotation to learn the STREAM framework. To evaluate learning outcomes, participants completed the same survey immediately before and after the session, and at the end of their 4-week rotation. Senior residents at another site who did not complete the workshop also evaluated their comfort leading debriefs. Results Fifty out of 65 senior residents (77%) participated in the workshop. After the workshop, participants felt more prepared to lead debriefs, learned a structured format for debriefing, and felt they had enough time to lead debriefs. Thirty-four of 50 (68%) workshop participants and 20 of 41 (49%) comparison residents completed the end-of-rotation survey. Senior residents who participated in the workshop were more likely than nonparticipants to report feeling prepared to lead debriefs. Conclusions A brief workshop is an effective method for teaching a framework for leading a team debrief. [ABSTRACT FROM AUTHOR]

We report the discovery of new lensed quasar candidates in the imaging data of the Hyper Suprime-Cam Subaru Strategic Program (HSC-SSP) Data Release 4, covering |$1\, 310\deg ^2$| of the sky with median seeing in the i band of ≈0.6 arcsec. In addition to two catalogues of Million Quasars Catalog v7.2 and AllWISE Catalog of Mid-Infra Red Active Galactic Nuclei, containing confirmed and candidate quasars, we preselect quasar sources using colour cuts from the HSC (grizy) and unWISE (W 1 + W 2) photometric data based on SDSS spectroscopic catalogues. We search for the presence of multiple point sources with similar colour through the convolution of the Laplacian of the preselected quasar image cutouts with the Laplacian of the point spread function, resulting in a reduction of lens candidates from 1 652 329 to 121 511 (7.4 per cent). After visual binary classification, we grade 6 199 (0.4 per cent) potential lenses on a scale of 0 to 3, with 3 indicating a lens and 0 indicating a non-lens. Finally we obtain 162 lens candidates with an average grade of ≥2, and among them, we successfully recover 18 known lenses. By fitting the light distribution and removing the known contaminants, we discover that 57 new systems contain at least two point sources and a galaxy in between, including 10 possible quadruply lensed quasars. This new sample exhibits a median separation of 1.26 arcsec and a magnitude limit of i ≈ 22. Spectroscopic or high-resolution imaging follow up on these newly discovered lensed quasar candidates will further allow their natures to be confirmed. [ABSTRACT FROM AUTHOR]

Production and use of engineered nanomaterials have grown substantially in recent years, leading to an increased potential for occupational exposure to these materials. Health and safety data remain largely unknown or incomplete for most engineered nanomaterials. The management of possible risks associated with engineered nanomaterials in the workplace is of paramount importance for workers, employers, and occupational health and safety (OHS) professionals and is a complex and developing field of research. A key component of risk management is the effective communication of known and potential risks in the workplace. Many proposals and recommendations have been made for signage to warn of the location and use of engineered nanomaterials within occupational settings. Such signage could raise awareness and serve as a reminder of the potential unknown health and safety risks presented by engineered nanomaterials. We have designed a simple visual pictogram intended to indicate the presence of engineered nanomaterials in the workplace. Herein, we present our pictogram in contrast with those concomitantly identified in various scientific guidelines and literature, provide details on a pilot-scale evaluation of this signage administered before a recent institution-level adaptation, and provide recommendations for those interested in implementing this signage in other workplaces. Strengthening risk communication by adapting this visual warning pictogram could help draw attention to potential risks, improve workplace hygiene, and ideally, decrease occupational exposure for those working with engineered nanomaterials. [ABSTRACT FROM AUTHOR]

It is well known that via the augmented Lagrangian method, one can solve Stokes' system by solving the nearly incompressible linear elasticity equation. In this paper, we show that the converse holds, and approximate the inverse of the linear elasticity operator with a convex linear combination of parameter-free operators. In such a way, we construct a uniform preconditioner for linear elasticity for all values of the Lamé parameter λ ∈ [ 0 , ∞). Numerical results confirm that by using inf-sup stable finite-element spaces for the solution of Stokes' equations, the proposed preconditioner is robust in λ. [ABSTRACT FROM AUTHOR]

Fire is a disturbance that serves to maintain the diverse mosaic of vegetation in the Eastern Deciduous Forest. However, our ability to reconstruct fire occurrence from hardwood tree scars still lags far behind our expertise in reconstructing fire history from conifers in the western United States. This study examines the fidelity of fire scaring in multiple tree species in the Big Oaks National Wildlife Refuge in Indiana, which is located in the central hardwood region of the Eastern Deciduous Forest. All 15 species, except for red oak, showed evidence of past fires, and most samples recorded multiple fire events. No fire scars were recorded in the latewood of the samples. Most of the fires scars occurred in the earlywood (May) suggesting the dormant season fires are likely associated with fires in March to April before the growing season begins. No synchronous fires were recorded across all sites, but fires occurred in 1981, 1982, 1984, 1985, and 1988 across multiple sites. This suggests that these were larger spreading fires. Establishment pulses were documented in association with fire events in 1981, 1984, and 1995, suggesting that fire may benefit the establishment or root sprouting of some hardwood species. Fourteen of the fifteen species that we sampled preserved fire scars, suggesting that the diverse suite of species in the Eastern Deciduous Forest is a viable sampling pool for examining fire history across this forest type. [ABSTRACT FROM AUTHOR]

A sustainable, bio-based, mesoporous material, Starbon A800, was explored for use as an adsorbent in solid phase extraction (SPE). A solution containing seven nitrosamines was first used as a standard to optimise conditions for extraction efficiency with Starbon A800. After optimising conditions, 25 compounds of varying polarity (terpenes, phenolics, pesticides, PAHs, amines, and nitrosamines) were extracted with SPE using either Starbon® A800, C18 or Porous Graphitic Carbon (PGC) as the adsorbent, for comparison purposes. At the same time, 3 different elution solvents (heptane, dichloromethane, and ethanol) were used for each type of adsorbent. Hansen solubility parameters can be used to choose an appropriate elution solvent for the selected SPE adsorbent. The best average SPE recoveries found for the 25 various compounds were 83%, 79%, and 65% using Starbon A800, PGC, and C18 adsorbents respectively and these had dichloromethane as the elution solvent. The identification and quantification of components was carried out using UV-visible spectroscopy, two-dimensional gas chromatography (GCxGC) with time of flight/mass spectrometry (TOF/MS) or a nitrogen chemiluminescence detector (NCD). The optimized method was successfully applied to extract volatile organic compounds from red wine and tap water using Starbon A800. Starbon A800 was shown to be a promising, low-cost, green, scalable, alternative adsorbent for the extraction of various types of organic compounds of a wide range of polarities using SPE. [ABSTRACT FROM AUTHOR]

Blueshifts – or, more accurately, blue asymmetries – in broad emission lines such as C  iv λ1550 are common in luminous quasars and correlate with fundamental properties such as Eddington ratio and broad absorption line (BAL) characteristics. However, the formation of these blueshifts is still not understood, and neither is their physical connection to the BAL phenomenon or accretion disc. In this work, we present Monte Carlo radiative transfer and photoionization simulations using parametrized biconical disc-wind models. We take advantage of the azimuthal symmetry of a quasar and show that we can reproduce C  iv blueshifts provided that (i) the disc-mid-plane is optically thick out to radii beyond the line formation region, so that the receding wind bicone is obscured; and (ii) the system is viewed from relatively low (that is, more face-on) inclinations (≲40°). We show that C  iv emission-line blueshifts and BALs can form in the same wind structure. The velocity profile of the wind has a significant impact on the location of the line formation region and the resulting line profile, suggesting that the shape of the emission lines can be used as a probe of wind-driving physics. While we are successful at producing blueshifts/blue asymmetries in outflows, we struggle to match the detailed shape or skew of the observed emission-line profiles. In addition, our models produce redshifted emission-line asymmetries for certain viewing angles. We discuss our work in the context of the C  iv λ1550 emission blueshift versus equivalent-width space and explore the implications for quasar disc wind physics. [ABSTRACT FROM AUTHOR]

While national parochialism is commonplace, individual differences explain more variance in it than cross-national differences. Global consciousness (GC), a multi-dimensional concept that includes identification with all humanity, cosmopolitan orientation, and global orientation, transcends national parochialism. Across six societies (N = 11,163), most notably the USA and China, individuals high in GC were more generous allocating funds to the other in a dictator game, cooperated more in a one-shot prisoner's dilemma, and differentiated less between the ingroup and outgroup on these actions. They gave more to the world and kept less for the self in a multi-level public goods dilemma. GC profiles showed 80% test–retest stability over 8 months. Implications of GC for cultural evolution in the face of trans-border problems are discussed. [ABSTRACT FROM AUTHOR]

The QED-physical (QED-P) theory [J. H. Wilson, Phys. Essays 35, 5 (2022)] is actually the theory Dirac sought in 1962 in his attempt to predict the muon as an "extensible model of the electron." Recently, Lerche attempted to produce a classical solution to Dirac's equation for the radial motion of an extensible, basically classical, model of the electron. Both Dirac and Lerche proceeded in the wrong, classical direction in this effort. The QED-P center of charge (CoC) position operator is derived directly from the Dirac equation (DE) CoC velocity operator, ca with no ad hoc assumptions. QED-P was integrated with QED into a single theory, and that integration is proved by the highly accurate estimates of QED that are dependent on the DE velocity operator ca. Both QED and QED-P are based directly on the same Dirac Equation (DE) four current c(a,I) that QED couples with an external electromagnetic field. QED uses covariant perturbation theory to produce highly accurate results, except for the electron selfenergy, which is infinite. The DE velocity operator, ca, is the spatial part of the free electron four current, and has highly unusual properties compared to classical velocity vectors. QED could not produce highly accurate answers without the 4Ã--4 complex matrix ca as the electron CoC "velocity" operator. QED-P simply integrates the same Dirac equation four current used so successfully in QED, and produces the discrete internal spatial and time coordinate operators (ISaTCOs) to give the electron field's internal structure a very specific, but highly, nonclassical geometric description, with no ad hoc assumptions. QED and QED-P are complementary theories, and both are proven to be true by the accurate results of QED. The physical interpretation of QED-P is discussed in this paper as a two-dimensional, rapidly vibrating "point" charge, that is always located on a 2D CoC sphere in the electron rest frame, oscillating rapidly through eight eigenvalues with an ISaTCO period of ~ 10-22 s. The fact that the CoC's eight ISaTCO spatial eigenvectors are always are located on a 2D shell encompassing the electron's 3D "space" inside the CoC's 2D shell is a direct consequence of the DE, and nothing else. In this paper, it is shown that the "discrete" ISaTCOs produce a one dimensional, discrete quantum harmonic oscillator with its ISaTCOs always located on a 2D CoC shell. The CoC shell is an "2D hologram" emerging from a 3D volume inside the 2D CoC shell with a vibrational electronic clock" producing an internal phase that is propagated throughout space/time. The QED-P point electron charge rotates 720° to complete one internal electron discrete period. The electron's spin and magnetic moment [J. H. Wilson, Phys. Essays 29, 402 (2016); ibid. 31(1), 59-67 (2018); ibid. 34, 17 (2021)] are generated by the CoC ISaTCO in QED-P, and there is no need for "intrinsic" properties. The QED-P electron properties described above d are far different than the standard model's very small point particle with intrinsic properties of spin and magnetic moment. [ABSTRACT FROM AUTHOR]

The open waters of large lakes can sometimes become so depleted in important metals that phytoplankton communities become either growth limited or limited in some metabolic function. Metals such as Fe, Ni, Mo, and Zn are used as co-factors for enzymes by phytoplankton in core metabolic functions, as well as metabolic pathways that allow phytoplankton to use less preferred forms of N and P (e.g. nitrates, urea, and organic phosphorus). In the Laurentian Great Lakes, metal limitation has been observed primarily in waters that are isolated from tributary inputs and sediment exchange. These are situations where the supply of metals is very low relative to demand. We hypothesized that another situation where metal limitation could occur is within algal blooms, where the demand for metals is high because preferred forms of N and P are often low or absent and the phytoplankton biomass is extremely high. As a preliminary test of this hypothesis, we performed seven laboratory incubation experiments on naturally occurring phytoplankton communities from two nearshore habitats that frequently experience blooms (Green Bay in Lake Michigan and Maumee Bay in Lake Erie). Metals and labile nutrients (inorganic N and P) were often present at low concentrations or below the method detection limit. Amendments of inorganic N (5 experiments) and P (1 one experiment) resulted in increased chlorophyll in laboratory incubations, but metal amendments alone never appeared to stimulate growth. Although we attempted to sample during conditions when we hypothesized metal limitation would be most likely, we cannot rule out the possibility that metal limitation is occurring at other times in these eutrophic nearshore areas. Further, metal availability could affect other aspects of the phytoplankton community, such as the production of cyanotoxins or the interactions between different phytoplankton taxa. Although harmful algal blooms are more likely to develop when external nutrient loads are high, while a bloom is occurring, the concentrations of key nutrients (nitrogen and phosphorus) can be very low. When key nutrients are in low abundance or absent, algae require additional metals to take advantage of poorer quality versions of these key nutrients. We hypothesized that metals might become growth-limiting in blooms, which might in turn have implications for predicting bloom toxicity. Seven experiments on phytoplankton from nearshore Great Lakes areas experiencing algal blooms did not show evidence for growth-limitation of algae, although the spatial and temporal extent of these experiments is limited. [ABSTRACT FROM AUTHOR]

The article offers information on the U.S. Food & Drug Administration (FDA) Modernization Act 2.0. It discussed about transitioning preclinical research beyond animal models and toward human cells, organoids; artificial intelligence/machine learning (AI/ML)-based approaches to improve the translation of potential therapeutics from the bench to the bedside; and the potential of human-induced pluripotent stem cells & organoids.

Phosphoinositide signaling lipids (PIPs) are key regulators of membrane identity and trafficking. Of these, PI(3,5)P2 is one of the least well-understood, despite key roles in many endocytic pathways including phagocytosis and macropinocytosis. PI(3,5) P2 is generated by the phosphoinositide 5-kinase PIKfyve, which is critical for phagosomal digestion and antimicrobial activity. However PI(3,5)P2 dynamics and regulation remain unclear due to lack of reliable reporters. Using the amoeba Dictyostelium discoideum, we identify SnxA as a highly selective PI(3,5)P2-binding protein and characterize its use as a reporter for PI(3,5)P2 in both Dictyostelium and mammalian cells. Using GFP-SnxA, we demonstrate that Dictyostelium phagosomes and macropinosomes accumulate PI(3,5)P2 3 min after engulfment but are then retained differently, indicating pathway- specific regulation. We further find that PIKfyve recruitment and activity are separable and that PIKfyve activation stimulates its own dissociation. SnxA is therefore a new tool for reporting PI(3,5)P2 in live cells that reveals key mechanistic details of the role and regulation of PIKfyve/PI(3,5)P2. [ABSTRACT FROM AUTHOR]

Objective: The objective is to analytically determine the expected CG and build hardware to measure and verify the suited subject's CG for lunar extravehicular activity (EVA) training in an underwater environment. Background: For lunar EVAs, it is necessary for astronauts to train with a spacesuit in a simulated partial gravity environment. NASA's Neutral Buoyancy Laboratory (NBL) can provide these conditions by producing negative buoyancy for a submerged suited subject. However, it is critical that the center of gravity (CG) for the human-spacesuit system to be accurate for conditions expected during planetary EVAs. Methods: An underwater force-transducer system and individualized human-spacesuit model was created to provide real-time measurement of CG, including recommendations for weight placement locations and quantity of weight needed on the spacesuit to achieve a realistic lunar spacesuit CG. This method was tested with four suited subjects. Results: Across tested weighout configurations, it was observed that an aft and high CG location will have large postural differences when compared to low and fore CG locations, highlighting the importance of having a proper CG. The system had an accuracy of ±5lbs of the total lunar weight and within ± 15 cm for fore-aft and left-right CG directions of the model predictions. Conclusion: The developed method offers analytical verification of the suited subject's CG and improves simulation quality of lunar EVAs. Future suit design can also benefit by recommending hardware changes to create ideal CG locations that improve balance and mobility. Application: The developed methodology can be used to verify a proper CG location in future planetary EVA simulations such as different reduced gravity training analogs (e.g. active cable offloading systems). [ABSTRACT FROM AUTHOR]

Objective: The effectiveness of lecture-based (LB) formats for residency education has recently been challenged as the gold standard. Studies suggest a flipped classroom (FC) lecture improves resident satisfaction, but evidence that showing improved knowledge acquisition is lacking. To determine whether the flipped classroom model improves knowledge acquisition compared to traditional LB model. Methods: Emergency medicine resident physicians at 2 academic programs were included in December 2019; at Sinai-Grace Hospital, a traditional lecture was the teaching method and at Detroit Receiving Hospital, FC was utilized. Residents completed prelecture and postlecture content tests. The primary outcome was change in test results (pretest to post-test). A noninferiority design comparing the changes between intervention and control groups was utilized (1-sided t-test, noninferiority margin of −0.5; 1-sided alpha = 0.05). Results: Results were available for 31 residents (17 controls and 14 interventions) out of 83 enrolled. There were 14 postgraduate year 1 (PGY-1), 9 PGY-2, and 8 PGY-3 residents. The mean difference in score was +0.71 (SD 1.38) and +0.77 (SD 1.48) for the FC and LB groups, respectively. This resulted in a mean difference between groups of −0.05 (lower bound of the upper 95% confidence interval −0.93 and therefore crossing the noninferiority margin of −0.05; P =.20). Conclusions: This study of resident education at 2 training programs was unable to demonstrate noninferiority of an FC format compared to standard lecture. Surprisingly, there was little improvement in test results after both teaching formats. Larger studies are needed to power results. [ABSTRACT FROM AUTHOR]

We present two- and three-dimensional hydrodynamic simulations of ∼kpc-scale AGN jets with mean jet powers in the range 1–7 × 1045 erg s−1, in which the jet power varies (through variation of the Lorentz factor) according to a flicker or pink noise power spectrum. We find the morphology and dynamics of the jet–cocoon system depends on the amplitude of the variability with a clear correspondence between the shape of the cocoon and the historical activity. The jet advances quickly during high-power states, whereas quiescent periods instead produce passive periods of inflation resembling Sedov–Taylor blast waves. Periods of high activity preferentially produce hotspots and create stronger backflow as they maximize the pressure gradient between the jet head and cocoon. The variability can also lead to propagating internal shock structures along the jet. Our work suggests that variability and flickering in the jet power has important implications, which we discuss, for observations of radio galaxies, ultrahigh energy cosmic ray acceleration and jet power to luminosity correlations. We explore the link between morphology and fuelling, and suggest that chaotic cold accretion should introduce a relatively small scatter in radio luminosity (∼0.2 dex) and modest imprints on morphology; sources such as Hercules A and Fornax A, which show evidence for more dramatic variability, may therefore require redder power spectra, or be triggered by mergers or other discrete events. We suggest ways to search for jet flickering observationally and propose that radio galaxies may be an important diagnostic of Myr time-scale AGN fuelling, due to their 'long-term memory'. [ABSTRACT FROM AUTHOR]

An experimental study was conducted on the wakes around three different obstacles confined between two parallel walls: semi-ellipsoids with the major axes of the base ellipses aligned in the streamwise and transverse directions, and a sphere. The Reynolds number was 1.78 × 10 4 based on obstacle height, H. Common to each of these geometries is a convex surface of the obstacle intersecting one or more boundaries, which was shown to result in a wall jet in the vicinity of the junction. Large streamwise counter-rotating vortex structures were found to be a robust feature of the wakes, which are referred to as lobes, due to their resemblance to previously coined lobe structures identified in the wake of a deeply submerged sphere. Inner lobe structures, of opposite sense to the primary lobes, were also observed in all cases, and it is proposed that the primary and inner lobe structures are formed by the wall jet deforming vorticity shed by the obstacle into a hairpin-like loop. Wavelet analysis of velocity time series on both sides of the wake revealed approximately antisymmetric vortex shedding in the ellipsoid wakes; however, intermittent in-phase shedding was observed in the wake of the sphere. This study showed that the shape of the obstacle junction (convex vs. flat) plays an important role in the behavior of the wake. [ABSTRACT FROM AUTHOR]

Using ≈190 000 spectra from the 17th data release of the Sloan Digital Sky Survey (SDSS), we investigate the ultraviolet emission line properties in z ≈ 2 quasars. Specifically, we quantify how the shape of C  iv  λ1549 and the equivalent width (EW) of He  ii  λ1640 depend on the black hole mass and Eddington ratio inferred from Mg  ii  λ2800. Above L / L Edd ≳ 0.2, there is a strong mass dependence in both C  iv blueshift and He  ii EW. Large C  iv blueshifts are observed only in regions with both high mass and high accretion rate. Including X-ray measurements for a subsample of 5000 objects, we interpret our observations in the context of AGN accretion and outflow mechanisms. The observed trends in He  ii and 2 keV strength are broadly consistent with theoretical qsosed models of AGN spectral energy distributions (SEDs) for low spin black holes, where the ionizing SED depends on the accretion disc temperature and the strength of the soft excess. High spin models are not consistent with observations, suggesting SDSS quasars at z ≈ 2 may in general have low spins. We find a dramatic switch in behaviour at L / L Edd ≲ 0.1: the ultraviolet emission properties show much weaker trends, and no longer agree with qsosed predictions, hinting at changes in the structure of the broad line region. Overall, the observed emission line trends are generally consistent with predictions for radiation line driving where quasar outflows are governed by the SED, which itself results from the accretion flow and hence depends on both the SMBH mass and accretion rate. [ABSTRACT FROM AUTHOR]

Observational and modelling studies indicate that earthquake ruptures can jump between fault sections as large as ∼3 and ∼5 km for compressional and extensional offsets, respectively. Here, we compare characteristics of the rupture jump process on parallel but offset fault sections from traditional 3-D dynamic rupture simulations governed by slip weakening friction using the finite element code, FaultMod, to those from quasi-dynamic simulations governed by rate- and state-dependent friction (rate-state friction) using the code RSQSim. These simulations use spatially uniform initial stresses. For a variety of measures the rupture renucleation position on the offset fault, the rate-state friction and slip weakening friction models produce very similar results. The principal difference is the additional occurrence of delayed rupture jumps that arise from the time- and stress-dependent nucleation that is characteristic of rate-state friction. For immediate rupture jumps, models with slip weakening friction span greater offsets than those with rate-state friction. However the jump distances are nearly identical when delayed rupture jumps are included in the comparisons. We propose that delayed rupture jumps are the likely mechanism for adjacent large-earthquake pairs and clusters. Based on the similarity of renucleation positions with both dynamic and quasi-dynamic models, we conclude that the renucleation positions for rupture initiation on the receiver fault (separated by less than ∼3 km from the source fault) are primarily controlled by static stress changes induced by slip on the initiating fault. However, in light of the slightly greater maximum jump distances (>3 km) seen with the dynamic slip weakening friction model, dynamic stress changes from seismic waves play an increasingly important role as offset distances increase. [ABSTRACT FROM AUTHOR]

Human neonates elicit a profound hypoferremia which may protect against bacterial sepsis. We examined the transience of this hypoferremia by measuring iron and its chaperone proteins, inflammatory and haematological parameters over the first post-partum week. We prospectively studied term, normal weight Gambian newborns. Umbilical cord vein and artery, and serial venous blood samples up to day 7 were collected. Hepcidin, serum iron, transferrin, transferrin saturation, haptoglobin, c-reactive protein, α1-acid-glycoprotein, soluble transferrin receptor, ferritin, unbound iron-binding capacity and full blood count were assayed. In 278 neonates we confirmed the profound early postnatal decrease in serum iron (22.7 ± 7.0 µmol/L at birth to 7.3 ± 4.6 µmol/L during the first 6–24 h after birth) and transferrin saturation (50.2 ± 16.7% to 14.4 ± 6.1%). Both variables increased steadily to reach 16.5 ± 3.9 µmol/L and 36.6 ± 9.2% at day 7. Hepcidin increased rapidly during the first 24 h of life (19.4 ± 14.4 ng/ml to 38.9 ± 23.9 ng/ml) and then dipped (32.7 ± 18.4 ng/ml) before rising again at one week after birth (45.2 ± 19.1 ng/ml). Inflammatory markers increased during the first week of life. The acute postnatal hypoferremia in human neonates on the first day of life is highly reproducible but transient. The rise in serum iron during the first week of life occurs despite very high hepcidin levels indicating partial hepcidin resistance. Trial Registration: clinicaltrials.gov (NCT03353051). Registration date: November 27, 2017. [ABSTRACT FROM AUTHOR]

In this issue of Cell Chemical Biology , Andlovic et al. 1 unravel how certain fusicoccin toxins synergize with interferon-α to kill cancer cells. The results suggest that fusicoccins potentiate apoptosis by "sticking together" 14-3-3 protein-protein interactions. In this issue of Cell Chemical Biology , Andlovic et al. unravel how certain fusicoccin toxins synergize with interferon-α to kill cancer cells. The results suggest that fusicoccins potentiate apoptosis by "sticking together" 14-3-3 protein-protein interactions. [ABSTRACT FROM AUTHOR]

A new study has revealed that neural amplification in mouse primary visual cortex substantially increases between training sessions as mice learn to detect novel optogenetic input directly into visual cortex, suggesting consolidation and recurrent network plasticity contribute to learning the behavior. [ABSTRACT FROM AUTHOR]

The stellate ganglion block (SGB) procedure has been used successfully for over twelve years to treat thousands of patients suffering from posttraumatic stress disorder (PTSD). Level 1b evidence supports this use of SGB, but no studies to date have reported specifically on anxiety symptom improvements following SGB. We collected Generalized Anxiety Disorder questionnaire (GAD-7) scores pre-procedure and at 1-week and 1-month post-procedure from 285 patients. The mean baseline GAD-7 score of 15.9 (indicating severe anxiety) declined significantly following SGB treatment. Changes in GAD-7 scores ≥ 4 were considered clinically meaningful. From baseline to 1 week, the GAD-7 scores dropped by 9.0 points (95% CI = 8.3–9.7, p < 0.001, d = 1.8), with 211 (79.6%) patients demonstrating clinically meaningful improvement. Furthermore, from baseline to 1 month, the GAD-7 scores dropped by 8.3 points (95% CI = 7.6–9.0, p < 0.001, d = 1.7), with 200 (75.5%) patients demonstrating clinically meaningful improvement. The stellate ganglion block treatment resulted in a decrease of GAD-7 scores of over twice the minimal clinically important difference in treating anxiety for at least 1 month following SGB. Given the results from this retrospective observational study, larger prospective studies should be conducted to determine the effects of SGB treatment as a novel therapeutic treatment for generalized anxiety disorder and other anxiety disorders. [ABSTRACT FROM AUTHOR]

Background: There is a pressing need for improved methods to identify effective therapeutics for diseases. Many computational approaches have been developed to repurpose existing drugs to meet this need. However, these tools often output long lists of candidate drugs that are difficult to interpret, and individual drug candidates may suffer from unknown off-target effects. We reasoned that an approach which aggregates information from multiple drugs that share a common mechanism of action (MOA) would increase on-target signal compared to evaluating drugs on an individual basis. In this study, we present drug mechanism enrichment analysis (DMEA), an adaptation of gene set enrichment analysis (GSEA), which groups drugs with shared MOAs to improve the prioritization of drug repurposing candidates. Results: First, we tested DMEA on simulated data and showed that it can sensitively and robustly identify an enriched drug MOA. Next, we used DMEA on three types of rank-ordered drug lists: (1) perturbagen signatures based on gene expression data, (2) drug sensitivity scores based on high-throughput cancer cell line screening, and (3) molecular classification scores of intrinsic and acquired drug resistance. In each case, DMEA detected the expected MOA as well as other relevant MOAs. Furthermore, the rankings of MOAs generated by DMEA were better than the original single-drug rankings in all tested data sets. Finally, in a drug discovery experiment, we identified potential senescence-inducing and senolytic drug MOAs for primary human mammary epithelial cells and then experimentally validated the senolytic effects of EGFR inhibitors. Conclusions: DMEA is a versatile bioinformatic tool that can improve the prioritization of candidates for drug repurposing. By grouping drugs with a shared MOA, DMEA increases on-target signal and reduces off-target effects compared to analysis of individual drugs. DMEA is publicly available as both a web application and an R package at https://belindabgarana.github.io/DMEA. [ABSTRACT FROM AUTHOR]

With rising healthcare costs and the rapid increase in remote physiologic monitoring and care delivery, there is an increasing need for economical, accurate, and non-invasive continuous measures of blood analytes. Based on radio frequency identification (RFID), a novel electromagnetic technology (the Bio-RFID sensor) was developed to non-invasively penetrate inanimate surfaces, capture data from individual radio frequencies, and convert those data into physiologically meaningful information and insights. Here, we describe groundbreaking proof-of-principle studies using Bio-RFID to accurately measure various concentrations of analytes in deionized water. In particular, we tested the hypothesis that the Bio-RFID sensor is able to precisely and non-invasively measure and identify a variety of analytes in vitro. For this assessment, varying solutions of (1) water in isopropyl alcohol; (2) salt in water, and (3) commercial bleach in water were tested, using a randomized double-blind trial design, as proxies for biochemical solutions in general. The Bio-RFID technology was able to detect concentrations of 2000 parts per million (ppm), with evidence suggesting the ability to detect considerably smaller concentration differences. [ABSTRACT FROM AUTHOR]

Background: Over 5 million patients in the United States have type 2 diabetes mellitus (T2D) with chronic kidney disease (CKD); antidiabetic drug selection for this population is complex and has important implications for outcomes. Objective: To better understand how providers choose antidiabetic drugs in T2D with CKD Design: Mixed methods. Interviews with providers underwent qualitative analysis using grounded theory to identify themes related to antidiabetic drug prescribing. A provider survey used vignettes and direct questions to quantitatively assess prescribers' knowledge and preferences. A retrospective cohort analysis of real-world prescribing data assessed the external validity of the interview and survey findings. Participants: Primary care physicians, endocrinologists, nurse-practitioners, and physicians' assistants were eligible for interviews; primary care physicians and endocrinologists were eligible for the survey; prescribing data were derived from adult patients with serum creatinine data. Main Measures: Interviews were qualitative; for the survey and retrospective cohort, proportion of patients receiving metformin was the primary outcome. Key Results: Interviews with 9 providers identified a theme of uncertainty about guidelines for prescribing antidiabetic drugs in patients with T2D and CKD. The survey had 105 respondents: 74 primary care providers and 31 endocrinologists. Metformin was the most common choice for patients with T2D and CKD. Compared to primary care providers, endocrinologists were less likely to prescribe metformin at levels of kidney function at which it is contraindicated and more likely to correctly answer a question about metformin's contraindications (71% versus 41%) (p <.05). Real-world data were consistent with survey findings, and further showed low rates of use of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists (<10%) in patients with eGFR below 60 ml/min/1.73m2. Conclusions: Providers are unsure how to treat T2D with CKD and incompletely informed as to existing guidelines. This suggests opportunities to improve care. [ABSTRACT FROM AUTHOR]

Background: In response to the US opioid epidemic, significant national campaigns have been launched to expand access to `opioid use disorder (MOUD). While adoption has increased in general medical care settings, specialty addiction programs have lagged in both reach and adoption. Elevating the quality of implementation strategy, research requires more precise methods in tailoring strategies rather than a one-size-fits-all-approach, documenting participant engagement and fidelity to the delivery of the strategy, and conducting an economic analysis to inform decision making and policy. Research has yet to incorporate all three of these recommendations to address the challenges of implementing and sustaining MOUD in specialty addiction programs.Methods: This project seeks to recruit 72 specialty addiction programs in partnership with the Washington State Health Care Authority and employs a measurement-based stepped implementation-to-target approach within an adaptive trial design. Programs will be exposed to a sequence of implementation strategies of increasing intensity and cost: (1) enhanced monitoring and feedback (EMF), (2) 2-day workshop, and then, if outcome targets are not achieved, randomization to either internal facilitation or external facilitation. The study has three aims: (1) evaluate the sequential impact of implementation strategies on target outcomes, (2) examine contextual moderators and mediators of outcomes in response to the strategies, and (3) document and model costs per implementation strategy. Target outcomes are organized by the RE-AIM framework and the Addiction Care Cascade.Discussion: This implementation project includes elements of a sequential multiple assignment randomized trial (SMART) design and a criterion-based design. An innovative and efficient approach, participating programs only receive the implementation strategies they need to achieve target outcomes. Findings have the potential to inform implementation research and provide key decision-makers with evidence on how to address the opioid epidemic at a systems level.Trial Registration: This trial was registered at ClinicalTrials.gov (NCT05343793) on April 25, 2022. [ABSTRACT FROM AUTHOR]

Background: The use of telemedicine increased dramatically in nursing homes (NHs) during the COVID-19 pandemic. However, little is known about the actual process of conducting a telemedicine encounter in NHs. The objective of this study was to identify and document the work processes associated with different types of telemedicine encounters conducted in NHs during the COVID-19 pandemic. Methods: A mixed methods convergent study was utilized. The study was conducted in a convenience sample of two NHs that had newly adopted telemedicine during the COVID-19 pandemic. Participants included NH staff and providers involved in telemedicine encounters conducted in the study NHs. The study involved semi-structured interviews and direct observation of telemedicine encounters and post-encounter interviews with staff and providers involved in telemedicine encounters observed by research staff. The semi-structured interviews were structured using the Systems Engineering Initiative for Patient Safety (SEIPS) model to collect information about telemedicine workflows. A structured checklist was utilized to document steps performed during direct observations of telemedicine encounters. Information from interviews and observations informed the creation of a process map of the NH telemedicine encounter. Results: A total of 17 individuals participated in semi-structured interviews. Fifteen unique telemedicine encounters were observed. A total of 18 post-encounter interviews with 7 unique providers (15 interviews in total) and three NH staff were performed. A 9-step process map of the telemedicine encounter, along with two microprocess maps related to encounter preparation and activities within the telemedicine encounter, were created. Six main processes were identified: encounter planning, family or healthcare authority notification, pre-encounter preparation, pre-encounter huddle, conducting the encounter, and post-encounter follow-up. Conclusion: The COVID-19 pandemic changed the delivery of care in NHs and increased reliance on telemedicine services in these facilities. Workflow mapping using the SEIPS model revealed that the NH telemedicine encounter is a complex multi-step process and identified weaknesses related to scheduling, electronic health record interoperability, pre-encounter planning, and post-encounter information exchange, which represent opportunities to improve and enhance the telemedicine encounter process in NHs. Given public acceptance of telemedicine as a care delivery model, expanding the use of telemedicine beyond the COVID-19 pandemic, especially for certain NH telemedicine encounters, could improve quality of care. [ABSTRACT FROM AUTHOR]

Just as leadingWestern countries have begun withdrawing from the neoliberal Washington Consensus that paved the way for economic globalization over the last 40 years, China has proposed an ambitious Belt and Road Initiative, or One Belt One Road, outlining its vision for global development. President Xi's vision of collectivist cosmopolitanism is centered on the principle of sovereign equality between nations, emphasizing civilizational uniqueness rather than universal human rights. In this view, economic and social development are path dependent, and in China's case, prioritize decolonization and national sovereignty. Xi's view in major speeches is cosmopolitan but collectivist, emphasizing economic growth, openness, dynamism, and an "avowed respect" for the integrity of other cultures, while saying nothing about individual human rights or groups within China. This approach positions ancient Chinese traditions like Confucianism as playing a central role in cultivating individuals' and society's moral qualities so that person, society, and governance are bound together as a mutually beneficial and interconnected whole. It forms the theoretical basis of a Chinese view of cosmopolitanism, which could be the basis of dialogue with Western cosmopolitanists. The challenge is reconciling the different emphasis accorded to human rights versus national sovereignty in the two views. Empirical results of a new measure of Cosmopolitan Orientation that correlates positively rather than negatively with nationalism and religiosity provide insights into the specific basis for this dialogue to become beneficial rather than conflictual. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The effectiveness of lecture-based (LB) formats for residency education has recently been challenged as the gold standard. Studies suggest a flipped classroom (FC) lecture improves resident satisfaction, but evidence that showing improved knowledge acquisition is lacking. To determine whether the flipped classroom model improves knowledge acquisition compared to traditional LB model. METHODS: Emergency medicine resident physicians at 2 academic programs were included in December 2019; at Sinai-Grace Hospital, a traditional lecture was the teaching method and at Detroit Receiving Hospital, FC was utilized. Residents completed prelecture and postlecture content tests. The primary outcome was change in test results (pretest to post-test). A noninferiority design comparing the changes between intervention and control groups was utilized (1-sided t-test, noninferiority margin of -0.5; 1-sided alpha=0.05). RESULTS: Results were available for 31 residents (17 controls and 14 interventions) out of 83 enrolled. There were 14 postgraduate year 1 (PGY-1), 9 PGY-2, and 8 PGY-3 residents. The mean difference in score was +0.71 (SD 1.38) and +0.77 (SD 1.48) for the FC and LB groups, respectively. This resulted in a mean difference between groups of -0.05 (lower bound of the upper 95% confidence interval -0.93 and therefore crossing the noninferiority margin of -0.05; P=.20). CONCLUSIONS: This study of resident education at 2 training programs was unable to demonstrate noninferiority of an FC format compared to standard lecture. Surprisingly, there was little improvement in test results after both teaching formats. Larger studies are needed to power results. [ABSTRACT FROM AUTHOR]

In North America, native unionid mussels are imperiled due to factors such as habitat degradation, pollution, and invasive species. One of the most substantial threats is that posed by dreissenid mussels, which are invasive mussels that attach to hard substrates including unionid shells and can restrict movement and feeding of unionids. This dreissenid mussel biofouling of unionids varies spatially in large ecosystems, such as the Great Lakes, with some areas having low enough biofouling to form effective refugia where unionid mussels might persist. Here, we measured biofouling on mussels suspended in cages over the growing season (generally first week in June to last week of August) over 3 years in nearshore areas in Lake Erie (2014–2016), Lake Michigan (Grand Traverse Bay, 2015 and Green Bay, 2016), and Lake Huron (2015). Biofouling varied substantially by years within Lake Erie, with increasingly higher biofouling rates each year. Although dreissenid mussels are present throughout these lakes, we observed very low biofouling in Grand Traverse Bay (Lake Michigan) and Saginaw Bay (Lake Huron), with no dreissenid mussels in 8 of 9 sites across these two bays. Sampling in the rivermouth of the Fox River (Wisconsin) and the Maumee River (Ohio) both showed very high biofouling in areas adjacent to the outlet of these tributaries into Green Bay and Maumee Bay (Lake Erie), respectively. These watersheds are dominated by agriculture, and we would expect high growth of primary producers (i.e., mussel food) and primary consumers (unionids and zebra mussels) in these areas compared to the other sampled bays or the open waters of the Great Lakes. [ABSTRACT FROM AUTHOR]

Quantifying the trophic basis of production for freshwater metazoa at broad spatial scales is key to understanding ecosystem function and has been a research priority for decades. However, previous lotic food web studies have been limited by geographic coverage or methodological constraints. We used compound‐specific stable carbon isotope analysis of amino acids (AAs) to estimate basal resource contributions to fish consumers in streams spanning grassland, montane and semi‐arid ecoregions of the temperate steppe biome on two continents. Across a range of stream sizes and light regimes, we found consistent trophic importance of aquatic resources. Essential AAs of heterotrophic microbial origin generally provided secondary support for fishes, while terrestrial carbon did not seem to provide significant, direct support. These findings provide strong evidence for the dominant contribution of carbon to higher‐order consumers by aquatic autochthonous resources (primarily) and heterotrophic microbial communities (secondarily) in temperate steppe streams. [ABSTRACT FROM AUTHOR]

How novel phenotypes evolve is challenging to imagine because traits are often underlain by numerous integrated phenotypic components, and changes to any one form can disrupt the function of the entire module. Yet novel phenotypes do emerge, and research on adaptive phenotypic evolution suggests that complex traits can diverge while either maintaining existing form–function relationships or through innovations that alter form–function relationships. How these alternate routes contribute to sexual signal evolution is poorly understood, despite the role of sexual signals in generating biodiversity. In Hawaiian populations of the Pacific field cricket, male song attracts both female crickets and a deadly acoustically orienting parasitoid fly. In response to this conflict between natural and sexual selection, male crickets have evolved altered wing morphologies multiple times, resulting in loss and dramatic alteration of sexual signals. More recently, we and others have observed a radical increase in sexual signal variation and the underlying morphological structures that produce song. We conducted the first combined analysis of form (wing morphology), function (emergent signal), and receiver responses to characterize novel variation, test alternative hypotheses about form–function relationships (Form–Function Continuity vs. Form–Function Decoupling), and investigate underlying mechanistic changes and fitness consequences of novel signals. We identified three sound‐producing male morphs (one previously undescribed, named "rattling") and found that relationships between morphology and signals have been rewired (Form–Function Decoupling), rapidly and repeatedly, through the gain, loss, and alteration of morphological structures, facilitating the production of signals that exist in novel phenotypic space. By integrating across a hierarchy of phenotypes, we uncovered divergent morphs with unique solutions to the challenge of attracting mates while evading fatal parasitism. [ABSTRACT FROM AUTHOR]

Since its initial identification in 1986, Lyme disease has been clinically diagnosed in 29 provinces in China; however, national incidence data are lacking. To summarize Lyme disease seropositivity data among persons across China, we conducted a systematic literature review of Chinese- and English-language journal articles published during 2005‒2020. According to 72 estimates that measured IgG by using a diagnostic enzyme-linked assay (EIA) alone, the seropositivity point prevalence with a fixed-effects model was 9.1%. A more conservative 2-tier testing approach of EIA plus a confirmatory Western immunoblot (16 estimates) yielded seropositivity 1.8%. Seropositivity by EIA for high-risk exposure populations was 10.0% and for low-risk exposure populations was 4.5%; seropositivity was highest in the northeastern and western provinces. Our analysis confirms Lyme disease prevalence, measured by seropositivity, in many Chinese provinces and populations at risk. This information can be used to focus prevention measures in provinces where seropositivity is high. [ABSTRACT FROM AUTHOR]

Background: The association between nonadherence to chronic medications and potentially preventable healthcare utilization and spending is largely unknown.Objectives: To examine the associations of chronic medication nonadherence with potentially preventable utilization and spending among patients who were prescribed diabetic medications, renin-angiotensin system antagonists (RASA) for hypertension, or statins for high cholesterol, and compare the associations by patient race/ethnicity and socioeconomic status.Design: Retrospective cohort study. Medicare fee-for-service claims data from 2013 to 2016 for 177,881 patients.Measures: Medication nonadherence was defined as having a below 80% proportion of days covered in each 6-month interval after the index prescription. Potentially preventable utilization was measured by preventable emergency department visits and preventable hospitalizations. Potentially preventable spending was calculated as the geographically adjusted spending associated with preventable encounters.Results: After adjustment for other patient characteristics, medication nonadherence was associated with a 1.7-percentage-point increase (95% confidence interval [CI]: 1.4 to 2.0 percentage points, p < 0.001) in the probability of preventable utilization among the diabetic medication cohort, a 1.7-percentage-point increase (95% CI: 1.5 to 1.9 percentage points, p < 0.001) among the RASA cohort, and a 1.0-percentage-point increase (95% CI: 0.8 to 1.1 percentage points, p < 0.001) among the statin cohort. Among patients with at least one preventable encounter, medication nonadherence was associated with $679-$898 increased preventable spending. The incremental probability of preventable utilization and incremental spending associated with nonadherence were higher among racial/ethnic minority and low socioeconomic groups.Conclusions: Improving medication adherence is a potential avenue to reducing preventable utilization and spending. Interventions are needed to address racial/ethnic and socioeconomic disparities. [ABSTRACT FROM AUTHOR]

New biophysical theory and electronic databases raise the prospect of deriving fundamental rules of life, a conceptual framework for how the structures and functions of molecules, cells, and individual organisms give rise to emergent patterns and processes of ecology, evolution, and biodiversity. This framework is very general, applying across taxa of animals from 10–10 g protists to 108 g whales, and across environments from deserts and abyssal depths to rain forests and coral reefs. It has several hallmarks: (1) Energy is the ultimate limiting resource for organisms and the currency of biological fitness. (2) Most organisms are nearly equally fit, because in each generation at steady state they transfer an equal quantity of energy (˜22.4 kJ/g) and biomass (˜1 g/g) to surviving offspring. This is the equal fitness paradigm (EFP). (3) The enormous diversity of life histories is due largely to variation in metabolic rates (e.g. energy uptake and expenditure via assimilation, respiration, and production) and biological times (e.g. generation time). As in standard allometric and metabolic theory, most physiological and life history traits scale approximately as quarter-power functions of body mass, m (rates as ∼ m –1/4 and times as ∼ m 1/4), and as exponential functions of temperature. (4) Time is the fourth dimension of life. Generation time is the pace of life. (5) There is, however, considerable variation not accounted for by the above scalings and existing theories. Much of this "unexplained" variation is due to natural selection on life history traits to adapt the biological times of generations to the clock times of geochronological environmental cycles. (6) Most work on biological scaling and metabolic ecology has focused on respiration rate. The emerging synthesis applies conceptual foundations of energetics and the EFP to shift the focus to production rate and generation time. [ABSTRACT FROM AUTHOR]

In the last year, we became aware that data used in our above‐referenced manuscript from 2018 published in Limnology and Oceanography contained significant errors. In the 2018 manuscript, we found that indices of secondary production were negatively correlated to indices of cyanobacterial abundance and toxicity. Unfortunately, one of our indices of cyanobacterial abundance (biovolume) and our measurement of toxicity (microcystin concentration) were inaccurate in the data we used in the 2018 manuscript. Upon discovering these errors, we immediately began correcting the repositories where these data were available. Having corrected those data repositories, we are now reporting on the re‐analysis of the data using the methods previously described in the 2018 manuscript. Although the relationships are slightly different, our interpretation is that the conclusions of the 2018 manuscript are still valid using the corrected data. The data errors we experienced were traced to a spreadsheet that was used to share data among the research team, which had errors caused by mistakes in copy‐pasting formulas instead of data and 'inadvertent' edits that were saved by the spreadsheet's auto‐save function. We apologize to the scientific community for these errors. [ABSTRACT FROM AUTHOR]

Competitive fitness assays in liquid culture have been a mainstay for characterizing experimental evolution of microbial populations. Growth of microbial strains has also been extensively characterized by colony size and could serve as a useful alternative if translated to per generation measurements of relative fitness. To examine fitness based on colony size, we established a relationship between cell number and colony size for strains of Saccharomyces cerevisiae robotically pinned onto solid agar plates in a high-density format. This was used to measure growth rates and estimate relative fitness differences between evolved strains and their ancestors. After controlling for edge effects through both normalization and agar-trimming, we found that colony size is a sensitive measure of fitness, capable of detecting 1% differences. While fitnesses determined from liquid and solid mediums were not equivalent, our results demonstrate that colony size provides a sensitive means of measuring fitness that is particularly well suited to measurements across many environments. [ABSTRACT FROM AUTHOR]

Background: Complex Regional Pain Syndrome (CRPS) is a disabling pain disorder that is most common after a distal limb fracture. While the acute systemic immune response to the injury is thought to play a role in the development of CRPS, this hypothesis has never been tested directly. Thus, we evaluated whether elevated levels of circulating pro-inflammatory cytokines early after a fracture were associated with the development of CRPS.Methods: We conducted a case-control study nested within a prospective cohort study. Individuals with wrist and/or hand fractures were recruited from specialist hand units. Baseline clinical data were obtained from participants within 28 days of fracture. CRPS status was determined 16 weeks after the fracture using a two-stage diagnostic process. Cytokine assays were obtained from all cases (defined using the Budapest criteria) and a random sample of those who did not have CRPS at 16 weeks. We calculated odds ratios with 95% confidence intervals to determine the risk of CRPS associated with the expression of each of 25 cytokines.Results: Baseline data were collected for 702 consenting participants, of whom 535 provided blood samples. Follow-up at 16 weeks was 97.2%. 15 (2.2% of the cohort) met the Budapest CRPS criteria and 69 (including those who met the Budapest criteria; 9.8%) met the International Association for the Study of Pain (IASP) CRPS criteria. In all of the primary analyses (using Budapest criteria) and 49/50 secondary analyses (using IASP criteria), 95% confidence intervals for the association between cytokine levels and the risk of subsequently developing CRPS included the null value (OR = 1). However, the confidence intervals were wide.Conclusion: There was no evidence that early post-injury expression of systemic cytokines was associated with a CRPS diagnosis 16 weeks after injury. This study does not provide support for the hypothesis that innate immune activation has a determinative role in the development of CRPS. [ABSTRACT FROM AUTHOR]

Recent work attributing decadal regime changes in temperature to radiative forcing is extended to atmospheric moisture. Temperature, and specific and relative humidity (T, q, RH) from the HadISDH data set were analyzed for regime shifts using the bivariate test. Most shifts in q and T for global and northern hemisphere (NH), and tropical land occurred within a year of each other. Only one shift of q was recorded in the southern hemisphere (SH). RH increased in the NH in 1990–91 and decreased in a series of shifts from the late 1990s, while in the SH decreased from 2001. The tropics have remained neutral, shifting negative over land and positive over the ocean. The global decreases in 2001 and 2011 was −0.56%. Global RH from 32 climate models from the CMIP5 RCP4.5 archive all contained regime shifts but only 4 reached or exceeded the observed decreases by 2100, the earliest in 2056. Regime shifts in RH and fire danger over Australia are consistent with the SH decreases in RH, shifting within one year of global fire season length in 2002, showing that impacts are also being underestimated by current analyses. Methods for nonlinear attribution and the contributing processes for nonlinear change are discussed. These results show that developing a better understanding of nonlinear change in moisture-related climate risk is an urgent task. [ABSTRACT FROM AUTHOR]

Objective: To examine variations in timing of lower-limb amputation (LLA) across race/ethnicity and sex among older adults with a diabetic foot ulcer (DFU). It was hypothesized Black/African Americans were more likely to have LLA post-DFU earlier compared with non-Hispanic/Whites, and more men would receive LLA earlier post-DFU compared with women.Research Design and Methods: This was a retrospective cohort analysis of enrolled Medicare fee-for-service (FFS) beneficiaries with a diagnosis of DFU during the study period (2012-2017), allowing up to 5 years post-DFU. Final analytic sample contained 643,287 individuals; the subsample consisted of 68,633 individuals with LLA only. The primary outcome was mutually exclusive groups based on timing of LLA. Multinomial logistic regression was applied to assess likelihood of membership into a group post-DFU based on characteristics such as sex and race/ethnicity.Results: Black/African American beneficiaries had 1.98 (95% CI 1.93-2.03) times the odds of receiving an LLA within 1 year of DFU diagnosis compared with non-Hispanic/White beneficiaries relative to no amputation. Female beneficiaries had increased odds (odds ratio [OR] 1.07, 95% CI 1.02-1.11] between 1 and 3 years and OR 1.08 [95% CI 1.03-1.12] in ≥3 years) of a delayed LLA compared with men among those that underwent LLA.Conclusions: Notably, these results present novel evidence on timing of LLA between racial groups and sex for Medicare FFS beneficiaries post-DFU. Results may be generalizable to individuals with Medicare FFS and DFU. Clinically more targeted, evidence-based decision making informs care decisions with opportunities to address inequities related to the social determinants of health that may lead to LLA. [ABSTRACT FROM AUTHOR]

[Display omitted] • PdAg/Al 2 O 3 catalysts were evaluated for the hydrogenation of acetylene to ethylene. • Catalysts were tested under industrially relevant and competitive conditions. • Catalysts were doped with Ru, Au and Sn; PdAgSn gave the highest selectivity. • The Sn content can also be optimised to modify the activity profile. • The selectivity enhancement was attributed to the electronic effect of Ag and Sn. • DFT analysis showed Ag and Sn increased the energy barrier for ethylene adsorption. PdAg/Al 2 O 3 catalysts were prepared using a simple and scalable preparation method. A systematic approach established a preparation-performance relationship which revealed that the Pd:Ag ratio and Pd reduction method affects the overall performance for the selective hydrogenation of acetylene to ethylene under industrially relevant tail-end reaction conditions. The addition of Sn improved selectivity with the optimum system achieving 97% selectivity towards ethylene, outperforming two industrial references. Density functional theory (DFT) simulations and electron microscopy analysis revealed that Sn integrates into the Pd lattice and increases the energy barrier for ethylene adsorption. This work demonstrates that Sn can be used to tailor catalyst performance for industrially relevant PdAg/Al 2 O 3 catalysts. [ABSTRACT FROM AUTHOR]